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Badar M. Mian

intraepithelial neoplasia in cystoprostatectomy specimens . Eur Urol 2001 ; 39( suppl 4 ): 30 – 31 . 32 Oyasu R Bahnson RR Nowels K . Cytological atypia in the prostate gland: frequency, distribution and possible relevance to carcinoma . J Urol

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Amy Ly, Jill C. Ono, Kevin S. Hughes, Martha B. Pitman and Ronald Balassanian

, radial scar in an excision specimen, and papilloma. Indeterminate lesions encompassed radial scar in a core biopsy, atypical papillary lesion, flat epithelial atypia (FEA), atypical ductal hyperplasia, atypical lobular hyperplasia/lobular carcinoma in

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Joshua I. Warrick

cancer (x400) consists of infiltrative small nests of tumor cells with minimal cytologic atypia. Histologic Variants Micropapillary Micropapillary morphology describes invasive small cancer nests with surrounding tissue retraction. 7 , 12

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James Saller, Christine M. Walko, Sherri Z. Millis, Evita Henderson-Jackson, Rikesh Makanji and Andrew S. Brohl

-like proliferation of spindle-shaped cells in cellular bundles and fascicles with marked nuclear atypia and cellular pleomorphism with numerous slit-like spaces containing erythrocytes ( Figure 1 ). Areas of necrosis, a prominent admixed inflammatory infiltrate of

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Karisa C. Schreck, Andrew Guajardo, Doris D.M. Lin, Charles G. Eberhart and Stuart A. Grossman

recurrence still showed classic PXA features, including scattered bizarre nuclei with prominent atypia and EGBs, but mitotic activity remained elevated (inset). variable pleomorphism, eosinophilic granular bodies, and frequent mitoses ( Figure 1C ). In

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Nalan Nese, Ruta Gupta, Matthew H. T. Bui and Mahul B. Amin

Edited by Kerrin G. Robinson

Carcinoma in situ (CIS) of the urinary bladder is defined as a flat lesion comprising of cytologically malignant cells which may involve either full or partial thickness of the urothelium. De novo CIS constitutes less than 3% of all urothelial neoplasms; however, CIS detected concurrently or secondarily during follow-up of urothelial carcinoma constitutes 45% and 90%, respectively, of bladder cancer. CIS is noted predominantly in male smokers in the sixth or seventh decade. Patients may present with dysuria, nocturia, and urinary frequency and urgency with microscopic hematuria. Cystoscopic findings may range from unremarkable to erythema or edema. Urine cytology is an important diagnostic tool. Cellular anaplasia, loss of polarity, discohesion, nuclear enlargement, hyperchromasia, pleomorphism, and atypical mitoses are the histopathologic hallmarks of CIS. Extensive denud ation of the urothelium, monomorphic appearance of the neoplastic cells, inflammatory atypia, radiation induced nuclear smudging, multinucleation, and pagetoid spread of CIS may cause diagnostic difficulties. Together with clinical and morphologic correlation, immunostaining with CK 20, p53 (full thickness), and CD44 (absence of staining) may help accurately diagnose CIS. Fluorescent in situ hybridization analysis of voided urine for amplification of chromosomes 3, 7, and 17 and deletion of 9p has high sensitivity and specificity for diagnosing CIS in surveillance cases. Several other molecular markers, such as NMP 22 and BTA, are under evaluation or used variably in clinical pathology. Intravesical bacillus Calmette-Guerin (BCG) instillation is considered the preferred treatment, with radical cystectomy being offered to refractory cases. Chemotherapy, α-interferon, and photodynamic therapy are other modalities that can be considered in BCG-refractory cases. Multifocality, involvement of prostatic urethra, and response to BCG remain the most important prognostic factors, although newer molecular markers are being evaluated for this entity. Patient outcome varies based on whether it is de novo development or diagnosed secondary to prior or concomitant papillary bladder cancer. From a clinical perspective, the principal determinants of outcome are extent of disease, involvement of prostatic urethra, response to therapy, and time to recurrence.

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Parijatham S. Thomas

excision, surveillance, and risk-reduction therapy. Clinical Presentation and Histologic Features In the initial study by Dupont and Page, 6 which noted that breast lesions with atypia carried a higher risk for breast cancer, breast biopsies were

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Arvind Bambhroliya, Mariana Chavez-MacGregor and Abenaa M. Brewster

their random periareolar fine-needle aspiration results. This study found that the uptake rate was 0% (0 of 51) in women found to have nonproliferative or hyperplastic cytology, 7% (2 of 30) in women with borderline atypia, and 50% (9 of 18) among women

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Mark H. Kawachi, Robert R. Bahnson, Michael Barry, J. Erik Busby, Peter R. Carroll, H. Ballentine Carter, William J. Catalona, Michael S. Cookson, Jonathan I. Epstein, Ruth B. Etzioni, Veda N. Giri, George P. Hemstreet III, Richard J. Howe, Paul H. Lange, Hans Lilja, Kevin R. Loughlin, James Mohler, Judd Moul, Robert B. Nadler, Stephen G. Patterson, Joseph C. Presti, Antoinette M. Stroup, Robert Wake and John T. Wei

, 70 Atypia, Suspicious for Cancer: Distinct from HGPIN, in which a basal cell layer is present, atypia is characterized by small single-cell layer acini. However, because so few glands are present on the biopsy specimen, an unequivocal diagnosis of

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Kathleen N. Moore and Joan L. Walker

and pathologic study of koilocytotic atypia . Ann N Y Acad Sci 1956 ; 63 : 1245 – 1261 . 5 Clavel C Masure M Bory JP . Human papillomavirus testing in primary screening for the detection of high-grade cervical lesions: a study of 7932